100. I live my life in lines, a series of graphs, dots, or blips, readings that register the health of my personal landscape. When the line goes up, mucous begins to slather around my mouth. I become groggy, lethargic, concrete blocks strapped to my shoes as I stumble and slam into things. Language rolls like a cascading stream. Water is what I need to avoid the looming coma. The line might go up because I’ve eaten too much sugar or miscalculated how much insulin I need to “cover” my meal—or there could be a technical glitch, such as an air bubble inside the tubing of my insulin pump, one not yet registered, one that the pump doesn’t tell me is blocking the passage of insulin I need to stay alive. Or it could just be stress triggering my high blood sugar. I pump myself with more insulin. I wait. The waiting is hardest. If the insulin doesn’t work, I’ll call 911.
When the line goes down, my body begins to shake. I get clammy. My vision becomes an episodic cut in the film reel; sequences need to be patched together; my thinking slows; language breaks off, repeats, is a staccato rhythm in the short-circuiting in my brain. I can respond, but I’m not there—not really, anyway. Friends tell me I make sense, but they know something is off. I’m agitated, which isn’t like me. Get food, my mind chants over and over as I, once again, stumble and slam around. I’ve sat on the floor in my apartment, honey jar open, my fist and mouth slathered in sugary syrup. When my lips cement together, I pry them apart with my gloopy hands because what else is there to do but stay alive? Or I’ll take three glucose tablets to shoot up my blood sugar to prevent a seizure. (Doctors always say to take one helping and wait fifteen minutes before taking another. Your blood sugar will come up, they say. You don’t want it to skyrocket in the other direction. But no doctor I’ve had is a diabetic, no doctor knows the stark reality of me sitting low on a kitchen floor so I won’t fall during a seizure, bash my head, cut myself on the countertop, and concuss my brain on the way down.) In the fit of a low, the body craves sugar, and it will do anything to prevent a seizure.
The best graphs, when I wake up, are a slow flat line—a stability during nighttime voyages. I dream of not having a seizure, of not being woken by my phone, alerting me my blood sugar is too high or too low. (Whether for a low or a high, you cannot sleep through the alarm—it is like the anemic cry of a bald eagle.) I keep glucose tablets on my nightstand—tropical fruit or raspberry flavor. They’re shaped like Necco wafers. I also have a nasal spray I can ram up my nostril, inject into my aerobic system, and shock my body back into a type of normalcy—I hope—by which I mean, registering how cold the sweat is on my body, how tense my muscles are, how weary my brain is, because, while low, nothing other than staying alive registers: it’s a do-anything-you-can-to-stay-alive moment. So far, I have never had a seizure alone.
101. The other graph that dictates my life follows Earth’s systems of heat and moisture and gas. Instead of measuring blood sugar, this graph measures parts per million of carbon in the atmosphere. Following this line illuminates new territory across the body of Earth—here the pine beetle gets to live just a little bit longer, eating more trees, compromising the forests of the American West. Here the ocean is a little higher and gnaws away at the Louisiana bayou. Here the air is a little warmer and carves away glaciers near the Hoh River. The line registers the seizure—or is it a type of coma?—that Earth is in, and is moving deeper into, because of our inability to help ourselves. So much depends on staying in range.
589. As a child I rarely went to the doctor for my diabetes. This period is faded from my mind, whether intentionally or not. Perhaps I didn’t—don’t can’t shouldn’t haven’t repressed omitted denied—want to recall going to the doctor to check the status of what made me different. Perhaps my parents couldn’t wouldn’t denied refused to take me out of coal country, a one-hundred-mile round trip to the doctor, to meet with a specialist who came from more than two hundred miles away, to check on my childhood diabetes. I do not know if my not going often to the doctor—like I now do—was a result of medical advice or of our lower-class limits of denial refusal horror pain suffering expense shame.
I do remember visiting the doctor when I was in eighth grade. My blood sugar was checked, well over 400. (Normal, nondiabetic blood sugar should be below 140.) The doctor looked between me and my mother. Her lips narrowed. “I want you to come back after lunch. And I want you”—here she pointed sharply aggressively angrily accusingly at me—“to drink two pitchers of water while you’re there. You do not leave that restaurant until you do.”
High blood sugar can result in something called diabetic ketoacidosis, which, even though it rhymes with supercalifragilisticexpialidocious, is anything but pleasant. When the body doesn’t have enough insulin, it starts breaking eating shaving down fat—and, in extreme cases, muscle. Because there’s not enough insulin in the body, glucose cannot be converted to energy. This results in producing ketones, a byproduct of this process. The body will try to discharge ketones through the urine, but if there are too many—if the blood sugar does not lower or the body cannot get rid of them quickly enough—blood can become poisoned, resulting in a coma. Or death.
I drank the two pitchers of water at lunch as my mother looked down at her plate and quietly unassumingly evasively worryingly tapped her finger on the table. I drank so hard quick fast concentratedly and in such large gulps that the water spilled down my shirt.
My mother contracted gestational diabetes while pregnant with me. After I was born, the diabetes went away for a year before it returned. There’s a history of diabetes on my mother’s side; my dad’s side too. I would make it five years before I was diagnosed with type 1 diabetes. I chugged guzzled slammed gulped water until my throat burned at that appointment too, and I wet myself, unable to make it to the bathroom.
When we returned to the doctor’s office from our lunch, she sat us down, sighed, and told us my test results were back. My A1C, a three-month average of my blood sugars, was back—it was over 16, which means my blood sugar, on average, was over 400. I do not know how long it was this high. Perhaps years. Perhaps, at times, my blood nearly transfigured into poison.
I didn’t stop wetting the bed until middle school. At friends’ birthdays, I was the only boy who, after nine p.m., was either sent home or picked up by a parent. When my parents would call a friend’s parent to tell them why I wouldn’t couldn’t didn’t want to was too embarrassed to spend the night, I prayed begged pleaded with them to make the parent promise pinkie swear they wouldn’t tell the friend. I did not want to be called a bed-wetter. My mother usually said, It’s safer for him to spend the night with us because he’s diabetic.
Each night in childhood I would wake and go run tiptoe slip sneak slide into the bathroom, turn on the faucet, cup my small hands, and drink twice from the tap. I always wanted to drink more. My mouth was syrupy slimy yet parched dry; my organs didn’t have enough grease to move the gears; they were desperate. What my body really craved needed cried for, I now know, was more insulin.
In the 1990s, it was common for me to have shots twice a day—once in the morning and once around supper. In the morning, I injected a preset dose of long-lasting insulin that stayed and worked in my body for roughly twelve hours. I would then test my blood sugar, make a calculation of how much fast-acting insulin I would need, and then inject it to bring my blood sugar back into a stable range. The problem with this method was that there were huge swaths of time—eight to ten hours—where I didn’t take the fast-acting insulin. This type of insulin starts to work fifteen minutes after taking it. It peaks within thirty to ninety minutes, and its effects last for three to five hours. I had no clue what my blood sugar was doing, and I had no idea what my body was undergoing.
Most mornings I woke to a lake in my bed, my pajamas sopping wet up to my belly. I’d pray the urine didn’t make it to the comforter, something about its big billowiness brought shame to me. I knew it was harder to wash. I knew my mother would sigh and become exasperated frustrated sad.
Some nights, by the time I woke, I had already wet the bed. I’d strip, take a washcloth across my body, put on a new pair of pajamas, and instead of removing my sheets, I’d try to find an island on my bed that wasn’t wet and sleep there. I figured that since I already had an accident, it wasn’t worth replacing my sheets in case I had another one.
The second dose of fast-acting insulin came before supper after I’d prick my finger, make a calculation, load my syringe, and stab myself in my stomach. I’d press the plunger and watch the cloudy milky silvery concoction that kept me alive disappear into me.
After supper came the second daily dose of long-lasting insulin, which would stabilize me until the following morning when I’d rise and shine and repeat the rhythm of staying alive with shiny glimmering sleek sharp syringes.
397. When I left for college, I began to read about accidents back home in western North Dakota. Oil, chemical, and saltwater spills swept down gullies, across the sagebrush steppe, into creeks, into the Little Missouri River. In 2006, with the advent of horizontal drilling, oil scions had a way to snake pipes into the sandwiched shale that previously was too difficult or too expensive to access. Towns exploded—doubling, tripling, quadrupling in size. One small town, Watford City, had a population of less than two thousand in 2010, and by 2012 was north of twelve thousand people.
398. What this means is more hotels more homes more restaurants more nurses more gas stations more emergency room technicians more alcohol are needed to keep a boom bustling booming blowing up bringing home the bacon.
399.By 2016, a Duke University study confirmed what we already knew: the Missouri River was radioactive poisoned disrupted contaminated harmful to humans toxic. All of those accidents found their way into the longest river system on the continent—one that more than 10 million people rely on for drinking water, one that farmers rely on to irrigate their wheat, corn, and soybeans. Eventually, all that radioactive water meets with the Mississippi north of St. Louis and flows into the Gulf of Mexico.
95. North Dakota, I now know, is everywhere.
103. It is in my body with the plastic catheters that deliver my insulin and read my blood sugar.
387. It is in the natural gas that is flared, rendering my home the largest bonfire on the planet visible from space slipping through your nostrils dear readers and into your lungs into your capillaries into your brain into your kidneys into the river that waters your wheat that grows your soybeans that grows your corn into syrup that makes its way into candy bars and soda pop.
97. At a doctor’s appointment in my early twenties, my endocrinologist told me that, by forty, I would need kidney transplants, that the pair of bean-shaped organs inside of me were damaged, that too much protein had spilled into my urine. I was put on a pill. Later, the dosage was increased, and then again.
98. The dosage always increases.
No doctor knows my stark reality.
99. I have seven years until I am forty.
100. Also, correct grammar is dictated by a healthy, normal glucose range.
417. Current scientific data give us until 2030 to be off of carbon—nine years away
but we may have already have might have
that threshold of
385. In 1988 the New York Times reported that James Hansen told a congressional committee that NASA was “99 percent certain that the warming trend was not a natural variation but was caused by a buildup of carbon dioxide and other artificial gases in the atmosphere.”
112. That was just a few months after I was born. I am a fossil fuel baby.
100. When I was a child, the few times I met with a pediatric endocrinologist, he told me that there would be a cure for diabetes within my lifetime.
417. As an adult I am told it is still possible to stop climate change, that all I have to do is stop eating meat fly less buy less reduce reuse recycle not have children buy organic buy Patagonia boycott go on strike limit rare earth metals not eat salmon not use plastic eat vegetarian eat vegan, which means more carbohydrates, which raise blood sugar, which slow down language, which elongates sentences by having to reduce reuse recycle, which is more carbon in the atmosphere because America is reduce reuse recycle meat fly less reduce recycle—
162. My body erodes.
418. Earth warms heats suffers jolts extincts retaliates destroys winnows.
129. By 2026, the global diabetic medical supply market is expected to be worth 38.5 billion dollars.
38. When a saltwater spill seeps across the sagebrush steppe,
In Ancient Ancient Ancient Ancient
World was per . . . miss . . . i.i.i.ble to do anything
to a con. quered peoples—rape
destroy h-h-homes—but to 40. salt the land. 45. It w-w-would 47. kill the olive trees, 50.ruin the s-s-soil 55.f or generations. 67. Nothing, they knew, would grow.
North Dakota, I now know, is everywhere.
100. Harold Hamm, the CEO of Continental Resources, an Oklahoma-based oil and natural gas company, has type 2 diabetes. Hamm has funded a world-renowned research center at the University of Oklahoma to help cure diabetes. Continental Resources is the major player in the destruction of my home in western North Dakota.
106. It’s not lost on me that the devil may be my savior.
237. The environmental movement does not talk
And why should it?
Being disabled isn’t sexy. It often
might mean you have
to be acknowledged
by yourself and others, and
disability isn’t often present in the pictures
of the Tetons, Muir Woods, or the Great Smokies. Disability,
and disabled people,
are often relegated to the periphery.
But the periphery 188. is where we need to pay attention. Liminal spaces of insight are imbued by the disabled community—166. When a person faces the reality of death daily, there is a power to their actions and their words. The misdiagnosis of the environmental movement, its focus on the—102—World to Come, misses the mark.
101. The World to Come is already here.
465. We know topsoil erosion compromises humans’
ability to grow food have shelter live by the sea live
in the forested mountains avoid tornadoes live in the Arctic live
near deltas in boreal forests on the dry prairie. We know great
hunks of ice are
breaking falling chipping cascading sloughing away—and
will continue to break away—from
Greenland and the Antarctic ice sheet. We know that
vagaries in weather are the new normal…….///////////???????????////////////?????
409. We have listened to the prophets of How to Maintain the Status Quo enough, buying selling colonizing into rhetoric that white, middle-class lifestyles will not need to change shift share reimagine reallocate repatriate acknowledge that the system can be tweaked altered shifted adjusted to keep everything hunky-dory calm cool and collected happy as a clam cool as a cucumber cool as a glacier cool as an SUV————— that capitalism can still lay claim on convenience comfort conformity.____________
122. But for the disabled, capitalism has been the enemy as far back as the Old Testament. The exile of the different-bodied, different-abled laid the groundwork for dis-memberment and the expulsion of those who looked, acted, or were perceived to be different. From that long arc of literature we find ourselves now, today, in an unworkable story—one where we have to adapt if humanity is to continue. And this adaptation looks more like listening to the disabled than buying a Prius.
124. To be disabled is to understand, daily, your own mortality. It is to acknowledge that, because of your very existence, your finances may be compromised—even if you have good insurance—that, like me, you will need to budget for visits to the endocrinologist, diabetes educator, primary care physician, pump supplies, vials of insulin, ketone strips to test your urine, blood glucose monitor, alcohol prep wipes to plunge your catheter into your love handles, and the constant companionship of your insulin pump, only removed to take a shower or to go for a swim—but not for too long, because it would mean your blood sugar will start to rise (no hour-long showers here). That to sleep is a constant discomfort because you have a hard piece of plastic tethered to your body by an eighteen-inch plastic tube, which makes you think about the oil it takes to deliver each of your supplies not only to your doorstep but also into you.
278. My body erodes like the badlands of western North Dakota. Shaped by fire wind and ice and time, the bentonite buttes calve away in winter, wash down into gullies in late summer, drift away in fall. My body is shaped by vagaries—brain damage from a seizure, vision blurred from retinopathy, a future without feet as capillaries weather the storm of diabetes.
289. The legend of my body reveals a future of kidney transplants blindness poor circulation amputation, a lower return on value, a decreasing price on the body that is me. Friends counsel me to take my time with my writing.
299. The story of my body is a story of erosion of diminution of time of skyrocketing price and bottom blowout sales on the inner workings of
373. I have pledged committed sacrificed focused
117. I cannot feel the plastic inside my body. I can feel the plastic on my body, the raised mounds like small hills rising from my torso. Because of them, I’ve developed a constant habit of holding my breath—my body seems to always be tense. I consciously remind myself to exhale. My breathing returns to normal for a few minutes until I forget to breathe again. The exhaling makes me tired, like I’m ready for a nap. It’s because of the knowledge of something on me—in me—the fear of bumping my plastic mounds, of my eighteen inches of plastic tubing that runs from my pump to my catheter site getting caught on a door handle—which it has, in the past—the snagging or
ripping out of the catheter.
42. Outside of the small town where I grew up in coal country swung a dragline; it slowly marched across the prairie
of western North Dakota……………………… its metal bucket………
gna…….wedaway at the d..r..y..p..r..airie soil.
At current consumption,
’s coal expect
50. In 2020, Great River Energy, Energy 51.
52. Energy.53.Energy.54.Energy.55.Energy.56. which supplies energy 57. to residents in Min60nesota and Wisconsin63, announced59.that the 56.C-C-coal 52.Crrrrrrrreek
. . .
. . .
. . .
. . .
75. Station and Falkirk Mine in Underwood, North Dakota, would close unless a buyer could be found. The company released a statement that wind energy was the future and coal was becoming too costly. Great River Energy said that it would even entertain the idea of “giving away” the two properties. In 2016, Great River Energy closed down the United Power Association’s Stanton Station plant, a large beige and red block of a building. Bricked on the banks of the muddy Missouri, I remember a large fly ash heap next to the plant as a child, how the black ash speckled and looked like stars against a night sky. We never fished for walleye, those golden emeralds, downstream from the fly ash pit.
350. I didn’t know then what I know now.
349. By mid-2018 the UPA Stanton Station was completely demolished removed with reclamation of the land under way.
377. There still is no reclamation for my kidneyshearteyesfeet. There’s only holding-the-frontline through diet pills exercise.
78. My body only knows erosion, and the pills I take for high cholesterol, high blood pressure, to protect my kidneys, at thirty-three, are to slow the ever-changing landscape of me. There is no refuge away from myself—no higher land away from rising seas, no Great Lake for freshwater, no safely living upstream from diabetes.
417. There are people who still believe climate change is a hoaxjokeconspiracy.
79. They do not believe my diabetes is a hoax.
222. I no longer can experience my diabetes without experiencing industrial capitalism, big pharma, climate change, and big agriculture. The food I eat to minimize the long-term complications of diabetes is more expensive than the corn syrup–subsidized diet of other Americans; my co-pays, medical appointments, unexpected medical costs are higher than most people’s my age. The logical end of industrial capitalism resides in my body: a plastic catheter made of fossil fuel, slipped into my fatty tissue in an attempt to keep my body healthy while the body of the planet erodes.
410. In 2014, it was announced that one of the continent’s largest oil pipelines would come through Story County, Iowa, where I was living at the time. Before moving there, I had spent the previous summer in western North Dakota interviewing landowners impacted by the o///il boom. Now I had put eight hundred miles between myself and the horrors I witnessed the f///laring of natural gas that made western North Dakota into a lake of fire the saltwater spills sloshing d????own steep coulees rendering the land sterile the accounts of “missing////women who to call if you had any information the derailed train of Bakken oil in Lac-Mégantic, Ontario, that spilled one mil////////lion gallons of oil killed forty-seven people forty-two bodies were found, meaning five pe///ople had been vaporized so that I could work on my b/oo/ks.
213. I ended up writing less and traveling the country more to share what I had seen in North Dakota, how the needle of industrial capitalism made landowners fend for themselves. How, under the Halliburton Loophole in the Natural Gas Act, the United States government could seize private land under eminent domain and give it to private corporations for development due to “public necessity and convenience.”
106. Oil and gas are now necessary and convenient for our lives. Insofar as I’m concerned, they’re necessary to keep me alive.
416. Insofar as the planet is concerned, if we keep burning carbon we’ll be squeezed out.
155. On August 31, 2016, nearly two years after learning that the 1,172-mile-long Dakota Access Pipeline was slated for construction, I was the first person arrested in Iowa for protesting against it. (My nephews live in North Dakota and drink radioactive water from the Missouri River.) Standing on steaming gravel in Boone County, I felt the cold snap of steel against my wrists before being hauled off with twenty-nine other people.
I wanted my nephews to inherit a different story, one where you can stand your ground, say No to the erosion of the things you love—of topsoil, of sage grouse, of bentonite buttes.
But how do I say No to the erosion of me?
A few weeks after I was arrested, I was interviewed on the radio. I mentioned on air that I was a type 1 diabetic. You know, she told me later, that was a real stupid thing you did.
69. Dear readers, I do not know how to convey that there is no waking moment when I am not reminded that I am diabetic, which is to say, there is no moment when I am unaware of erosion, of transformation, of the slow and quick march toward death. On my left hip is my insulin pump, on my right oblique is my blood sugar sensor—the plastic of the two either digging into my hip or pulling on my shirt. The pump rotates every three days, the sensor every ten. Sleeping on my belly and hip is now complicated; I do not sleep on my back. But to be reminded of my being diabetic is, by implication, to remind me of the erosion of life itself—of the winnowing of the sage grouse, the disappearing of the milk-colored pallid sturgeon, of the godwits no longer nesting near New Town, North Dakota, due to the flaring of natural gas. You see, dear readers, disaster is embodied in me. Disaster looms. It is in the numbers.
187. There is no day off from being diabetic. Whenever I turn my phone over to check my blood sugar, I see a rising and falling line, the amount of sugar in my bloodstream—and then I think about the amount of carbon in the air. They are one and the same, really—monitoring the reefs, the disappearing Marshall Islands, the expansive sweep of the pine beetle, the thinning rivers of the American West, the suffering of a dying body.
402. The consumption of fossil fuels is our modern chronic illness.
417. There is no day off from the pain that is here and the pain that is to come.
4 2 0
4 2 1 4 2 2 4 2 3 4 2 5 4
Prairie fires can ignite veins of coal beneath the striking bentonite buttes of North Dakota’s badlands. As the subterranean seams burn, the fumes shape unruly junipers into tall columns of growth stretching toward the sky.